Health officials use secure Web site to exchange information

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Before the triple-checked facts of an outbreak are released to the public or first responders, doctors and epidemiologists have discussed their observations, ruled out rumors and exchanged advice.

The Epidemic Information Exchange, known as Epi-X, provides a forum for health professionals to instantly notify others of an outbreak, research and create reports on specific health topics, and track information. The secure Web site brings together various health professionals and the Centers for Disease Control and Prevention in a free exchange of information.

"It occurred to us that we needed to build a real-time network that would link public health officials and that wasn't secret but was behind the scenes," said T. Demetri Vacalis, associate director in CDC's office of scientific and health communications. "It's really very dynamic and it's instant."

The site was created nearly a year before the Sept. 11, 2001, terrorist attacks and grew with the anthrax attacks in October 2001, the severe acute respiratory syndrome outbreak and the recent emergence of monkeypox in the Midwest.

Health professionals have posted more than 1,000 reports since its inception, including information on West Nile virus, a new strain of the flu, food recalls and unknown illnesses in children or travelers.

Now, more than 1,200 health care professionals log on to share reports and request assistance. The network is secured with encryption technology which requires a digital certificate and a password. The network allows for varying levels of access to users, who are determined by what are known as gatekeepers in each state, Vacalis said.

Using Epi-X, public health workers receive daily e-mails, alerting them to reports and actions in their target areas. The system also provides emergency notifications in the case of an outbreak of bioterrorism attack. Sticking to set parameters, such as a region or profession to be notified, the system can make 5,000 phone calls in less than 5 minutes, leaving an automated message and running down a list of contact numbers for each person, Vacalis said.

"We're using this more and more as CDC progresses," Vacalis said, noting the notification system can be used internally to send alerts about how to manage an outbreak and who should or shouldn't show up for work if an incident occurs at the CDC.

Once the information about a disease has been confirmed as fact, the data can then be released to the public through the Morbidity and Mortality Weekly Report. The MMWR is the official voice for scientists, doctors, press and the general public. Starting as a paper report in the 1800s, the MMWR eventually moved to the CDC and morphed into the electronic format which now reaches 20 million to 40 million readers each week through various distributors, Vacalis said.

Although Epi-X can be a valuable tool, it reaches a relatively small population, said Georges Benjamin, executive director of the American Public Health Association.

"I think it works fine, but it has a limited distribution," he said. "It's good for them, but there needs to be more."